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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

Advocacy & Compliance

Healthesystems’ Advocacy & Compliance experts are essential in the management of pharmacy and ancillary benefits for our clients. By tracking and influencing regulatory activity, our team stays  ahead of evolving trends and identifies opportunities to advocate on behalf of our clients, their injured workers, and the broader industry.

The Advocacy & 
Compliance Team

Monitors and reports on proposed and pending regulatory changes that impact workers' comp, helping shape effective program strategies

Advocates for fair and balanced public policy through proactive engagement with regulators, customers, and other stakeholders throughout the rulemaking lifecycle

Supports operational compliance by providing guidance to internal stakeholders and external partners during the implementation of new regulatory changes

Regulatory Recap

A weekly e-newsletter informed by the Advocacy & Compliance team to help keep our clients and industry contacts in the know on the latest legislation and policy updates impacting workers’ comp.
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NCCI Reports on Interstate Regional Cost Differences

The report provides a collection of actuarial metrics across three of the NCCI’s largest jurisdictions by population – Florida, Illinois, and Texas.
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December 15, 2025

Indiana and Washington Introduce Provider Choice Bills

If enacted, Indiana House Bill 1069 would go into effect July 1, 2026, while Washington Senate Bill 5847 would go into effect June 30, 2027.
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December 15, 2025

New York Pharmacy Network Bill Vetoed by Governor

The bill would have duplicated existing protections for filling certain prescription out-of-network.
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December 8, 2025

Expanding Access to Care Across the Country

Delaware reported success with a recent bill, while Washington State is undergoing rulemaking and the U.S. Senate introduced a new bill.
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December 8, 2025

Pennsylvania Supreme Court Reviews Drug Pricing Case

The case will examine the Bureau of Workers’ Compensation’s use of RED BOOK for calculating AWP.
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December 8, 2025

CMS Publishes 2026 Q1 NCCI Edits

Changes will impact DME supplier services, facility outpatient hospital services, and practitioner services.
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December 8, 2025

Delaware and Pennsylvania Expand Medical Data Call Reporting

Insurers with 0.25% of market share must begin sharing data by July 1, 2026, while those with lower market share must begin by January 1, 2027.
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December 8, 2025

Nevada Schedules Workshop to Review Reform Rule Changes

This workshop will cover rules around panel provider lists, delegating follow-up care to physician assistants, and other clerical matters.
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December 8, 2025

Texas Finalizes Designated Doctor Plan-Based Audit

The audit will evaluate the medical necessity and reasonableness of referrals and diagnostic testing ordered by designated doctors.
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November 24, 2025
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 Further resources you may be interested in

Additional articles and updates from Healthesystems related to policy shaping workers’ comp.

California Proposes Psychedelics Pilot Program

Five treatment centers would offer psychedelic therapy for veterans and former first responders.
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Healthesystems at WCI 2024

Adjusters Assemble! Visit Healthe at Booth #921 to learn how we reduce day-to-day burdens for claims professionals.
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Child Labor Laws are Changing: How Could This Impact Workers’ Comp?

An increase in the teen workforce could impact workplace injury and claims management.
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New Jersey Proposes Worker Heat Protections, Continuing Recent Trend

As another state considers protections, WCRI publishes new data on heat’s impact on workplace accidents.
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More States Continue with PTSD Legislation

Oklahoma and Rhode Island enact new presumptions, with Georgia adding extra coverage.
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Maryland and Arizona Enact New Psychedelic Laws

A Maryland taskforce will plan regulation, while Arizona will tentatively cover MDMA treatment for first responders with PTSD.
Read More
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